Counselling and PsychotherapyKentish Town NW5 & Finchley N3

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What fake news tell us about uncertainty.

Fake news owes some of its success to our incapacity to tolerate uncertainty. It can be easier and less painful to believe that our streets are teeming with malicious terrorists than to have to cope with feeling lost, discarded, scared, purposeless, or any of the other emotions that manifest as feelings of uncertainty.

Fake news gives us reassuringly easy, if improbable, answers with which to fill a very uncomfortable void. But a degree of uncertainty is a necessary component of the therapeutic process and is often expressed in statements like “I don’t know why I feel this way”. The temptation is then to fill that gap with a definitive answer; “I / you feel this way because…”.

The real reasons we feel the way we do are rarely quite so cut and dried. Our feelings about any given situation are composed of layers of similar experiences and influences, each one overlapping the other; those experiences will be unique to each and every one of us. Allowing a degree of uncertainty gives us space to explore, reflect and understand. Space we don’t have if we rush to fill the void with a glib or simplistic answer.

Uncertainty is anxiety provoking but can prove very valuable. Instant certainties can be the psychological equivalent of fake news – temporarily satisfying but ultimately misleading.

14 March 2018

On International Women's Day

Today is International Women's Day so I've taken a little time to reflect on the differences between the women and men who have sought my help over the years.

The single biggest difference is this: 99% of the women I have seen in my consulting room have been sexually assaulted. That's right. 99%. To put that into context, I have been seeing clients for 10 years from every imaginable background and circumstance. That's a lot of women.

And the men? While some have experienced sexual assault with devastating consequences, it is by no means as universal.

The assaults described by these women vary in the degree of violence, frequency, relationship to perpetrator etc, but the stark fact remains that I spend a great deal of my working life facing the trauma inflicted by sexual violence towards women and girls.

Sexual trauma can be ruinous, and can echo around us for decades after the event, but that doesn't need to be the end of the story. Sexual violence is survivable. Not in a let's-just-pretend-it-never-happened way that feeds our collective denial about the subject, but in a truthful way. Finding the freedom and safety to talk about the experience can begin to repair the damage and unlock the silencing burden of shame that so many survivors carry.

And so, on International Women's Day, I wish us all (women and men) freedom from sexual violence and intimidation. And if we can't have that yet, I wish us all the courage and support to confront and transcend the trauma we have endured.

8 March 2017

How do we know if we are narcissistic?

Today I was contacted by a journalist wanting to talk about narcissism and social media, a topic as complicated as it is popular.

At the end of our conversation she asked me if we would know if we were narcissistic. But narcissism isn’t necessarily a bad thing, we are all narcissistic to a greater or lesser degree. We all need validation now and then, we all need to pay attention to ourselves and to how are feeling and doing. There is such a thing as healthy narcissism, and it is expressed through good self-esteem and self care.

However narcissism is more commonly thought of as negative. Essentially, people who have high levels of narcissism use other people as their mirror, they need to receive a positive image of themselves reflected back at them most of the time and may get upset, angry or withdrawn when a consistently high level of positive reinforcement isn’t forthcoming.

High levels of narcissism (self regard, self obsession and feelings of specialness) are just strategies we have developed to cope with feeling small and deeply wounded. A wound that originates in early childhood, injures and warps our budding sense of self and leaves us needing high levels of validation and reassurance and often feeling destroyed by relatively minor criticism.

Unhealthy narcissism can be destructive as we cannot fully and reciprocally relate to others. If we only use other people to validate and elevate us then that is damaging and will ultimately leave us feeling lonely and unloved.

So, to try and answer the original question, how do we know if we are unhealthily narcissistic? We could start by asking ourselves some honest questions such as: 1. Can I really put myself in other people’s shoes? 2. Do I turn every conversation back round to me?3. Am I only able to use myself as a frame of reference, e.g I’m feeling bad so you should too, I did it so can you, It’s all my fault, I’m better / worse off than everyone else.4. Do you secretly believe that you are better / much worse than most people you meet?

Answering no to the first question and yes to the last three may mean you are more narcissistic than is entirely healthy. However, it may also mean that you are having a bad day as we can all feel as though we are at odds with the rest of the world when we are vulnerable and struggling (which is the great failing of these kinds of ‘assess yourself’ type questions).

You could ask a trusted friend what they think. Or, perhaps, you could book an initial appointment with a therapist and talk it through with them?

16 February 2017

Hate hurts

The US election result is less than two days old and in my little corner of the world, as in so many others, the impact is being felt.

Since the result was confirmed on Wednesday morning, the levels of anxiety amongst some of my clients, and the levels of anxiety that some of my colleagues are seeing, has risen sharply. It's not just that people are catastrophising or projecting their anxiety onto events they cannot control (which is what we see a lot of on social media); what really seems to be hurting is the fear that the election result further legitimises hate.

LGBT clients, people born of immigrant parents, or who are immigrants themselves are understandably scared. The vocal, and now sanctioned, bigotry of the election campaign taps into and builds on people's past experiences of predjudice and discrimination.

Being on the receiving end of life-long discrimination cumulatively and toxically erodes our sense of self and self-worth, leaving us feeling painfully unsafe, inadequate, ashamed and consequently vulnerable to debilitating anxiety and depression.

The therapy room is a safe space where we can talk without being judged, where we are able to express ourselves freely regardless of where we were born or who we love.

And this week, for a lot of people, the world feels more unsafe, more intolerant, more directly threatening. It is very early days, we can't begin to grasp the ramifications of this election result yet for the UK. But certainly in my consulting room, the effects are being felt and the value of a safe space feels that much more poignant.

10 November 2016

Brexit Blues

As I write we are days into post-referendum Britain. The main political parties seems to be eating themselves alive and no-one know where we are heading or how we are going to get there.

With this climate of unprecedented political and economic uncertainty it is no wonder that I am noticing significantly increased levels of anxiety. Huge divisions have opened up as a result of the vote, with rifts in families and friendships severed overnight.

It is no exaggeration to say that some Remain voters are feeling distraught and furious, while some Leave voters are wounded and baffled by the hostility directed at them.

So here is an article to try and help you make sense of what you may be feeling at the moment. Here's hoping clarity emerges from the chaos.

Here is an interesting article on links between social media and narcissism. The article explores whether social media causes unhealthy levels of narcissism, or whether it just makes high levels of narcissism more noticeable than they are offline. I have to admit to a vested interest here though as I am quoted in the article: Social Media and Narcissism

Perhaps your anxiety is telling you something

Early on in my training I was told the following apocryphal story …….

A man walks into a doctor’s office with his right arm awkwardly locked, his elbow at a right angle to his body and his hand held up against his neck. After a thorough physical assessment, the doctor prescribes muscle relaxants and suggests hypnosis.

The man duly undergoes hypnosis which successfully frees up the spasmed arm. He then kills himself by cutting his own throat with his now mobile right hand.

It’s a grisly probable myth with multiple versions, but, the point of it (and the reason it was told to me) is to illustrate that sometimes symptoms have a meaning or a purpose of their own. In this case, the man’s rigid arm was his unconscious protection against acting on his desire to end his life.

Mindfulness is a meditative practice often aimed at lowering anxiety and stress levels. It can be very effective in helping people find ways of stopping their mind racing, repeatedly imagining the worst, and feeling out of control. If you were to go to your GP today reporting high anxiety you might well be handed a leaflet on local mindfulness courses. And you might find such a course very useful indeed.

However, rather like the doomed man with the rigid arm, it might be that your anxiety is telling you something worth listening to.

People who have a history of trauma often exist in a state of hyper-vigilance, which means that they are semi-permanently poised to respond to threat, whether real or perceived. The threat may be long-gone but their bodies have remained in fight-or-flight mode as a means of physical and psychological survival. They are therefore likely to experience high levels of anxiety.

Many people who have a history of trauma fear a more relaxed state as, in removing or reducing their anxiety, they can feel life-threateningly vulnerable. Sometimes anxiety, like the mythical man’s arm, is an unconscious protection against traumatic memories. Asking a traumatised individual to let go of their anxiety has the potential to be re-traumatising as you are asking them to remove the mechanism that they feel is keeping them safe.

I suppose the moral of these stories, apocryphal or not, is that careful, thorough assessment is absolutely essential before any psychological intervention is attempted.

"I don't think we're meant to do it alone"

Late last year Brene Brown said, about self-help “I don’t think we’re meant to do it alone”. The Guardian

Her comment got me thinking about the various messages we take from the self-help industry.

For some, self-help books can feel like a life-line, a way of connecting with your own sense of agency in a world where many feel powerless. For some, they provide helpful new ways of addressing difficult situations. However, the message we take from the self-help industry isn’t always so benign.

Our capacity to meaningfully use self-help depends on what the term ‘self-help’ means to us. Do we take it to mean, as Brown implies, that we are meant to sort ourselves out armed with a couple of books or podcasts and a few free hours? Does it mean that we, as individuals, are exclusively responsible for our own wellbeing; that all accountability for our contentment rests firmly on the single self? If so, then it’s a short step to concluding that it is up to you alone to help yourself, if you don’t / can’t then you are lazy and deserve the misery you are wallowing in.

I have heard so many people say that if only they could ‘think more positively’ or ‘challenge my negative thoughts’ or ‘take responsibility’ then they would feel so much better. And, of course, there can be a great deal of sense in all those statements. It is also true that taking responsibility for our emotional states can be a necessary and liberating process.

But the difficulty lies in the emphasis being exclusively on the self, on an individual striving to feel better by shouldering the responsibility of their mental state in isolation. Because that just isn’t going to work. Nobody can face up to their darkest thoughts and most distressing feelings alone. We need a real, felt, human connection.

Undoubtedly, part of the self-help appeal can be the idea that we fix ourselves by ourselves, that we don’t need to take the risk of making ourselves vulnerable to another human being. But it is precisely the process of taking that risk and connecting with another that allows us to unfold.

If we want to feel better, to take charge of a life that feels like it is spinning out of control, then we need a support network within which to do that. We are relational creatures, hardwired to respond to and depend on each other. Like most other mammals our survival depends on it.

Sometimes the message we take from self-help is one of relentless self-reliance, whereas perhaps what we really need to learn is mutual healthy interdependence.